Document Detail


Changes in effective connectivity of the primary motor cortex in stroke patients after rehabilitative therapy.
MedLine Citation:
PMID:  16828743     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We used a perturb-and-measure approach, by combining transcranial magnetic stimulation (TMS) and positron emission tomography (PET), to examine changes in the primary motor area (M1) and its effective connectivity in stroke patients with chronic motor deficits (>1-year post-stroke) who underwent 3 weeks of constraint-induced movement therapy. During the 3-week period, 7 patients spent 4 h per day performing shaping exercises with the affected arm under our supervision for 14 days and wore a mitt on the unaffected arm at home in situations where safety was not compromised. Anatomical magnetic resonance imaging confirmed that all patients had lesions that encompassed the white matter; no patient had damage in the hand representation of M1. Improvements on various motor tests were observed immediately after therapy and 1 month afterwards. During the TMS/PET sessions, we applied trains of subthreshold 10-Hz repetitive TMS over the hand representation of the ipsilesional and contralesional M1s and varied the number of TMS trains delivered during each scan. The results demonstrate changes in the local response of TMS in the ipsilesional and contralesional M1, changes in the strength of interhemispheric connectivity between M1s, and changes in the effective connectivity of the ipsilesional and contralesional M1s with the non-primary motor areas, the basal ganglia, and the motor nuclei of the thalamus.
Authors:
Philippe A Chouinard; Gabriel Leonard; Tomás Paus
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2006-07-07
Journal Detail:
Title:  Experimental neurology     Volume:  201     ISSN:  0014-4886     ISO Abbreviation:  Exp. Neurol.     Publication Date:  2006 Oct 
Date Detail:
Created Date:  2006-09-15     Completed Date:  2006-12-05     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0370712     Medline TA:  Exp Neurol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  375-87     Citation Subset:  IM    
Affiliation:
Cognitive Neuroscience Unit, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada.
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MeSH Terms
Descriptor/Qualifier:
Aged
Brain Mapping
Cerebrovascular Circulation / physiology
Evoked Potentials, Motor / physiology
Exercise Movement Techniques
Female
Humans
Male
Middle Aged
Motor Cortex / physiopathology*
Movement / physiology
Positron-Emission Tomography
Recovery of Function / physiology
Stroke / physiopathology*,  rehabilitation*
Transcranial Magnetic Stimulation
Comments/Corrections
Comment In:
Exp Neurol. 2007 Apr;204(2):491-5   [PMID:  17331501 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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